Provider Demographics
NPI:1366009581
Name:JWEID, DANIELLE (LPC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:JWEID
Suffix:
Gender:F
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4638 GUAM ST # A
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-1412
Mailing Address - Country:US
Mailing Address - Phone:315-790-8838
Mailing Address - Fax:
Practice Address - Street 1:1553 BRADFORD RD STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4094
Practice Address - Country:US
Practice Address - Phone:757-453-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA15-217221700000X
VA0701008333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist